Corynebacterium

/Co·ry·ne·bac·te·ri·um/ (-bak-ter´e-um) a genus of bacteria including C. ac´nes, a species present in acne lesions, C. diphthe´riae, the etiologic agent of diphtheria, C. minutis´simum, the etiologic agent of erythrasma, and C. pseudodiphtheri´ticum, a nonpathogenic species present in the respiratory tract.

Corynebacterium Clinical

ORGANISM:

Genus: Corynebacterium
Species: diphtheriae

GENERAL CONCEPTS:
Corynebacteria belong in the family Mycobacteriaceae and are part of the CMN group (Corynebacteria, Mycobacteria and Nocardia).The family Mycobacteriaceae are Gram-positive bacteria, nonmotile, catalase-positive and have a rodlike to filamentous morphology (Corynebacteria are often pleomorphic). As a group, they produce characteristic long chain fatty acids termed mycolic acids. In the image to the right, the R-groups represent these chains. For Corynebacteria, chains of 28-40 carbons are common; for Nocardia, chains of 40-56 carbons are produced; for Mycobacteria, the chains are 60-90 carbons in length.

DISTINCTIVE PROPERTIES:
Corynebacterial cell walls contain thin spots which leads to some Gram variability and “ballooning” that produces a “club-shaped” cell. Old cells store inorganic phosphate, which can appear as metachromatic granules when stained.

PATHOGENESIS:
C. diphtheriae is the etiologic agent of diphtheria.
These organisms colonize the mucus membranes of the respiratory tract and produce the enzyme neuraminidase which splits N-acetylneuraminic acid (NAN) from cell surfaces to produce pyruvate which acts as a growth stimulant.
C. diphtheriae also produces diphthin, which is a protease that inactivates IgA.

The toxin that is produced is a single polypeptide of 62,000 daltons and contains a single disulfide cross-link. Digestion with trypsin gives 2 fragments, A and B. The B (binding) fragment attaches to cell surfaces then proteases release the A (active) fragment to enter the cell. In the cell, the toxin acts as an ADP-ribosyltransferase, inactivating translation factor EF2.

HOST DEFENSES:
Humoral immunity (antitoxin) is important in preventing disease.

EPIDEMIOLOGY:
Diphtheria exists throughout the world and occasional outbreaks occur almost yearly.
The Schick test can be used to ascertain population risk. This test involves the injection of a minute amount of the diphtheria toxin under the skin. The absence of a reaction indicates immunity.

Laboratory: Tellurite media is the agar of choice for isolation of Corynebacteria, which produce jet black colonies.

CONTROL:
Sanitary: Reduce carrier rate by use of vaccine.
Immunological: A vaccine (DPT) prepared from an alkaline formaldehyde inactivated toxin (i.e. toxoid) is required. Passive immunization with antitoxin can be used for patients.
Chemotherapeutic: Penicillin, erythromycin or gentamicin are drugs of choice.

Types of Corynebacterium

Corynebacterium bovis

A common inhabitant of the bovine udder but not considered to be a pathogen. May have importance in protecting the udder from more damaging pathogens.

Corynebacterium pyogenes

Corynebacterium rathayi

See clavibacter toxicus.

Corynebacterium renale

Previously classified as types I, II and III, but now allocated separate names of C. renale, C. pilosum and C. cystitidis, respectively. Causes contagious bovine pyelonephritis, and balanoposthitis of bulls, and plays a large part in causing enzootic balanoposthitis in sheep.

Corynebacterium suis

Recently called Eubacterium suis; now called Actinobaculum suis.

Corynebacterium ulcerans

A rare cause of subacute bovine mastitis, but a recognized risk for people who drink raw milk.